Quote from: calicarly on July 06, 2016, 12:09:55 PM
Hi Denjin,

Thanks Hun I got the referral with no problem. I printed out Remacle's email and the GP seemed to be pretty agreeable to it and said just snap a pic while the endoscopy is happening and took a copy of the email so just so they know to expect me to want the image.

I hope you're right that the strep won't affect things. Sure makes me feel better to read that.. I got some antibiotics in the meantime... I'm only a week and a day into recovery. When did you start talking? I know yeson has different post op directions...

I'd imagine, worst case, that the strep would just interfere with the healing and make it take a bit longer, dunno.  It affects higher up in the throat than the actual vocal cord area I think?

No speaking for a month with Yeson although I started doing a little bit at three weeks.  You'd need to ask Brenda in her thread about the differences as she's more familiar with the Remacle side of things.  No idea why everyone has different recommendations..

So is the incomplete glottal closure (whatever you want to call it) just a normal thing that takes time?  Yeson won't reply to my emails now... reminds me of how Suporn quit speaking to me when I had complications.

I always had replies from Yeson when I was worried. Its just that they seem to get a lot of requests and sometimes they do not know what to say, also Jessie always has to ask Dr Kim if it is more complicated and that depends on him having the time. I would not worry and if there is no reply in 1-2 weeks, maybe send another short email. Always keep emails short, Jessie does not like pages long emails

The incomplete closure is AFAIK rather common. I think it gets better with healing, but mostly it gets better with training. Basically it probably means that some muscles are pulling the vocal folds apart while you are trying to speak. This is in part realted to the "vocal tremor" that Dr Kim describes, but also it can be bad habits, the muscles not yet being adapted to the new situation or your subconscious doing weird things - also consider that an incomplete closure at the back end is present in a majority of women - so it it is that, I would not worry at all.

Thanks, Anja.  The ENT was pretty terrible, so I don't know the full details... Hopefully they really did refer me to the voice clinic and I can get a good answer.

On a separate note - it's so hard to get rid of old habits.  My voice feels stressed today (phone calls, etc.).  So, I record my voice and I'm speaking at like 240Hz. My relaxed voice should be nearer to 210... this means I'm still unconsciously going into the pre-surgery habits.  It's a long road!

Quote from: Denjin on July 11, 2016, 06:09:40 AM
So is the incomplete glottal closure (whatever you want to call it) just a normal thing that takes time?  Yeson won't reply to my emails now... reminds me of how Suporn quit speaking to me when I had complications.

Don't worry sweetie as my case is the same and Professor Remacle said it's normal. Here is the video of my vocal folds showing it : https://sendvid.com/yt2mzvg8

He said that this will go over time and volume will be ok then.

As Anjaq said, be patient with Dr Kim's response because he is very busy but he will reply you.

What a weird video - you do not see anything when you are making a sound... why is that?

Mine looks like this:
https://sendvid.com/nhlsuxiu

you can see that at the Top (back) it does not close completely, but the SLT and the doctor said that this is pretty normal for many or even most women, so I am not giving it much worries anymore

Thanks, Anja and Brenda.  Yeah a quick google does show that incomplete glottal closure is the norm, really.  One day I'll get a video and see exactly where it was happening.

Overall I'm pretty happy now, though.  Can only imagine how happy I'll be after I have lots of time to heal and get used to things.

Hey Denjin! How has the past week or so been? Any updates?

Quote from: andreah on July 20, 2016, 12:10:29 PM
Hey Denjin! How has the past week or so been? Any updates?

HI   No major changes in a while I don't think... But, I will post a month 4 update next week sometime, with new recordings.  It's definitely a long process as I notice I fall into old speech patterns sometimes which push my voice too high (for me anyway) and put some undue stress on everything.

Never did get the referral mail, either, so perhaps the rubbish ENT didn't refer me to the speech clinic.

Those of you were were told to start taking clonezepam, I have a questions...  When and why were you told to start taking it?

Obviously he said I may need to take it when the botox wore off, but after my three month recordings were sent I was told not to start taking it.  Is it something he might say after he gets my month four recordings?

I took it after I experienced some decline in voice quality after about 3 months , I did a recording and sent it in and Dr Kim said to take the pills. If you do not need them (yet), I would not take them. They are a bit tough - some have side effects of them, most have withdrawal symptoms when stopping them. So unless the Dr says to take them, I would not do so.

Same as Anjaq, around 4thonth my voice started breaking.  I don't think clonazopam has helped much though. I do lots of breathing exercises that help with that.

Like Anjaq said, Clonazopam can have some serious side effects. Do read about them before u decide to take it!!

Thanks, Anja and Ritana, for the replies.  I have no idea, then.  I do still have a tremor, but honestly that is never going to go away and shortening the cords will make it worse anyway.  The whole botox thing for it seems a scam in retrospect.  However, the recordings sounds decent enough to Dr. Kim.  I'll do a 4 month one in a few days and see what they say.

Well, I am not sure, but i think the Botox nd Clonazepam helped me to learn to use my voice in a way that has less tremor. It does not always work , though, sometimes I just get a lot of tremor and roughness again, but on other days it works

Hmm, could be.  I don't notice it unless I try to hold certain notes for a long time, though.  We'll see in a few days.

Also, turns out I was referred to a speech centre and go in two weeks.  The reservation call seemed like it was for a speech therapist, though, so hope they sent me to the right place!

Ah ok - thats not a bad tremor then. I have the issue that it leads to making my voice go into vocal fry or gives it a buzz at times - so it does affect my speaking voice. And that is a bit less now after 2 rounds of clonazepam

Quote from: anjaq on July 23, 2016, 02:18:01 AM
Ah ok - thats not a bad tremor then. I have the issue that it leads to making my voice go into vocal fry or gives it a buzz at times - so it does affect my speaking voice. And that is a bit less now after 2 rounds of clonazepam

Eep!! Hopefully it does go away over time.  Definitely don't have anything like that here and just asked my partner to confirm. It's just a tiny bit worse when making long 'tones'.

Should count my blessings I guess.

Well I did have issues with that before the surgery - so its not something new. It has most likely something to do with those 18 years of mistreating my poor voice

Something I see in my voice and it may be common to all of us is we may be using a range that is lower than we should be. I find roughness in my voice when I am relaxed and I allow the pitch to drop. If I bring the pitch up a bit, the voice soothes out and seems to work much better. It may have to do with the fact that our vocal cords while shorter are still more massive that a CIS woman's and we need a bit more tension to prevent the cords from flopping around when in used. Any opinions on this thought?

That may well be. Another explanation is - the same thing does happen with other women who bring their voice down low - so it may really just be that its that thing about the brain adapting to the right tension  to use to make the voice clear at the pitch is is now good at. We still think "relaxed" is lower than it really is now.
No human can speak with totally relaxe vocal folds - you always need some tension to make a controlled sound.

Another possible explanation is, that with too much relaxation the new "commissure" may not be stable in position. it is after all held in place by soft tissue and muscles and not by cartilage.

I have videos of ma vocal chords and they do show that there is sometimes an asymmetry - as if someone pulls one of the vocal folds to the side and leaves the other in place. I think this is what the "tremor" means - some muscles pull that one side away from the center line where otherwise they would just meet and make a clean sound